Burekovic Azra, Dizdarevic-Bostandzic Amela, Godinjak Amina
Clinic for endocrinology, diabetes and metabolic disorders, Clinical center of University of Sarajevo, Bosnia and Herzegovina.
Medical Intensive Care Unit, Clinical center of University of Sarajevo, Bosnia and Herzegovina.
Med Arch. 2014 Jun;68(3):163-6. doi: 10.5455/medarh.2014.68.163-166. Epub 2014 May 31.
Diabetes mellitus, the most frequent endocrinology disease is a predisposing factor for infections. Diabetic patients have 4,4 times greater risk of systemic infection than non diabetics.
a) To determine the prevalence and characteristics of acute infectious diseases in hospitalized diabetics; b) To correlate values of blood glucose levels and HbA1c with acute infections in hospitalized diabetics; c) To identify the etiology of infectious diseases.
The study included 450 diabetic patients hospitalized in the 24-month period in the Intensive care unit of the Clinic for Endocrinology, Diabetes and Metabolic Disorders CCUS. In 204 patients (45,3%) there was an acute infectious condition and the following data was registered: a) gender and age; b) basic illness; c) laboratory parameters of inflammation (Le, CRP); d) blood glucose upon admission, parameters of glucoregulation (HbA1c, fructosamine); e) type of infection; f) verification of etiological agent; g) late complications of diabetes; and h) outcome.
Out of 204 diabetic patients with infection, there was 35,3% men and 64,7% women. More than half of patients (61%) were in the age group 61-80 years. The most common primary disease was Diabetes mellitus type 2. HbA1c and fructosamine were significantly increased in diabetic patients with acute infection compared to diabetics without acute infection. There is a positive correlation between HbA1c levels and CRP, and blood glucose and CRP in diabetic patients with acute infection. Most frequent infections: urinary tract infection (70,0%), followed by respiratory infections (11,8%), soft tissue infections (10,3%), generalized-bacteremia / sepsis (6,9%). The most common cause of urinary infection and generalized infection was Escherichia colli. The most common bacteria causing soft tissue infections was Staphylococcus aureus.
Almost half (45,3%) of hospitalized diabetic patients had acute infectious condition. They present most frequently in women, aged 61-80 years, with Type 2 Diabetes mellitus. HbA1c and fructosamine were significantly increased in diabetic patients with acute infection. There is a positive correlation between the parameters of inflammation and glucoregulation in diabetics with acute infection. Most frequent was a urinary tract infection and the most common causative agent was Escherichia coli. The most common cause of soft tissue infections was Staphylococcus aureus. Out of 21 patients with verified soft tissue infections, 18 of them (85,7%) had confirmed diagnosis of diabetic microangiopathy diabetica. A total of 96,1% of patients fully recovered.
糖尿病是最常见的内分泌疾病，是感染的一个诱发因素。糖尿病患者发生全身感染的风险是非糖尿病患者的4.4倍。
a）确定住院糖尿病患者急性传染病的患病率和特征；b）将血糖水平和糖化血红蛋白值与住院糖尿病患者的急性感染相关联；c）确定传染病的病因。
本研究纳入了在内分泌、糖尿病和代谢紊乱临床中心重症监护病房住院24个月期间的450例糖尿病患者。204例患者（45.3%）存在急性感染情况，并记录了以下数据：a）性别和年龄；b）基础疾病；c）炎症实验室参数（白细胞、C反应蛋白）；d）入院时血糖、糖调节参数（糖化血红蛋白、果糖胺）；e）感染类型；f）病原体鉴定；g）糖尿病晚期并发症；h）结局。
在204例感染糖尿病患者中，男性占35.3%，女性占64.7%。超过一半的患者（61%）年龄在61 - 80岁之间。最常见的原发性疾病是2型糖尿病。与无急性感染的糖尿病患者相比，急性感染的糖尿病患者糖化血红蛋白和果糖胺显著升高。急性感染的糖尿病患者中，糖化血红蛋白水平与C反应蛋白、血糖与C反应蛋白之间存在正相关。最常见的感染：尿路感染（70.0%），其次是呼吸道感染（11.8%）、软组织感染（10.3%）、全身性菌血症/败血症（6.9%）。尿路感染和全身性感染最常见的原因是大肠杆菌。引起软组织感染最常见的细菌是金黄色葡萄球菌。
近一半（45.3%）的住院糖尿病患者存在急性感染情况。他们最常见于61 - 80岁的女性，患有2型糖尿病。急性感染的糖尿病患者糖化血红蛋白和果糖胺显著升高。急性感染的糖尿病患者炎症参数和糖调节之间存在正相关。最常见的是尿路感染，最常见的病原体是大肠杆菌。软组织感染最常见的原因是金黄色葡萄球菌。在21例经证实的软组织感染患者中，18例（85.7%）确诊为糖尿病微血管病变。共有96.1%的患者完全康复。
